Russell, Jessica Nicole Jack

Russell, Jessica Nicole Jack is an individual health care provider with primary practice located at 425 Niles Cortland Rd Se , Warren OH 44484-2478. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Russell, Jessica Nicole Jack can be contacted via phone (330) 856-3975.

Contact Information

Primary practice address
425 Niles Cortland Rd Se Warren OH 44484-2478
Phone: (330) 856-3975
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X I.1901879 Ohio

Profile Details

NPI number 1184776692
LBN Legal business name Russell, Jessica Nicole Jack
Credentials LISW
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 17th, 2007
Last updated Nov 4th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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